CD30 positive systemic anaplastic large cell lymphoma - brentuximab vedotin initial PBS authority application form (PB123)

Use this form for a patient starting initial Pharmaceutical Benefits Scheme (PBS) subsidised treatment with brentuximab vedolin.

Download and complete the CD30 positive systemic anaplastic large cell lymphoma - brentuximab vedotin initial PBS authority application form.

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Page last updated: 20 February 2020